Network Magazine Summer 2017 | Page 63

BUILDING AB STRENGTH FOR EVERY FEMALE CLIENT By assessing core control and prescribing exercise accordingly, we can minimise injury and maximise performance for every female client, from postnatal to postmenopausal, says Dianne Edmonds. omen returning to fitness post-pregnancy and childbirth, whether that be at six weeks, six months or six years, can present to you with physical changes that need specific attention when programming. These can include a lengthened abdominal wall, an excessive abdominal muscle diastasis (gap between the two sides of the rectus abdominis) and/or a potentially compromised pelvic floor. Personal trainers need to consider these issues when prescribing abdominal exercises for female clients, and to assess the level of core control and match it with appropriate levels of exercise. This will assist in minimising injury and maximising performance for clients who are in the postnatal year, and who have previously had children, as well as those who are postmenopausal. Planks and mountain climbers are commonly prescribed for core training, but for some clients these are unsuitable due to their lower level of core control, or an underlying area of weakness in their pelvic floor or abdominal wall. Establishing a client’s baseline first will help you to protect their pelvic floor and abdominal wall and retrain their core, rebuilding from the inside out – and setting the foundations for performing a safe and strong plank. W Assessing a client’s core When assessing a client’s core, you should consider the following changes. Lengthened abdominal wall In instances where the abdominal wall is unrehabilitated from previous pregnancies, it may function better when recruitment is started from a lengthened position, such as in 4 point kneeling, rather than in shortened position such as supine. Check and progress each client from the optimal starting positions for them. Balance between the layers of the abdominal wall muscles Clients who have done extensive training involving the upper rectus abdominus and external obliques will often have preferential recruitment of these muscles when activating the core. Checking the client’s depth of control of the deeper layer, using the pelvic floor to activate with transversus abdominus and internal oblique activity prior to strong engagement of the outer muscles, can assist in restoring the balance between the layers of the abdominal wall. Look for an ‘in-drawing’ of the lower abdominal region, with relative relaxation of the upper abdominals under the rib cage. Abdominal muscle separation While a proportion of abdominal muscle diastasis cases resolve spontaneously, some women will have an unresolved diastasis ‘gap’ of over 2cm and will need specific attention placed on avoiding strain on the linea alba and, ideally, reducing the size of the gap. Start by assessing for a diastasis in supine: if one is present then it is important to check for closure and avoidance of any bulging or widening with exercise. Pelvic floor Based on the fact that 1 in 3 women who have ever had a baby will have a problem with urinary incontinence, and 1 in 2 women may have a pelvic organ prolapse, it is likely that some of your female clients will experience these problems. Some women are more at risk, particularly if they have had multiple births, a tear that extends NETWORK SUMMER 2017 | 63